Oireachtas Joint and Select Committees
Tuesday, 8 February 2022
Joint Committee On Health
General Scheme of the Mental Health (Amendment) Bill 2022: Discussion (Resumed)
Dr. Donal O'Hanlon:
The term itself is misleading. We use medications to alleviate distress and treat illness. Most people who come into hospital are suffering from a very acute phase of illness. That is the criterion for admission. Even the use of the term "chemical restraint" is quite misleading. In any other branch of medicine, we would be using medication to relieve suffering, treat the illness and relieve distress.
There is a further problem with the section regarding physical restraint and chemical restraint as it is termed and the draft Bill. Some 80% of admissions to inpatient units are voluntary. We really encourage people to come in as voluntary patients. It is highly preferable. That has been very much the ethical position from psychiatrists and other multidisciplinary staff for years. We are very comfortable with that. However, they are coming in in a very acute phase of illness. Unfortunately, some of them exhibit behaviours that are difficult to control, for example, self-laceration on a ward or attempting to harm themselves by banging their head on the wall. These are very much a minority of those patients who come in as voluntary. However, they present a real challenge in how to keep them safe and how to keep their neighbour in the next bed safe.
I am not sure this is workable if there is an absolute ban on using such techniques in order to ensure safety and in order to relieve distress for 80% of the patients coming into adult-approved centres. In the centre I am most involved with, we have 29 beds and at night we have four nurses. I do not know how we are going to make that work. I think there will be many injuries for other patients and for staff. I ask the committee to take that into consideration.
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